Journal of Nuclear Cardiology

, Volume 25, Issue 2, pp 389–393 | Cite as

What is This Image? 2018: Image 5 Result

Insidious disease
  • Vasvi Singh
  • Saurabh Malhotra


Myocardial perfusion SPECT often points towards other non-coronary etiologies of chest pain. Here, we report one such insidious condition.

Clinical History

A 54-year-old male with a history of ascending aortic aneurysm and a history of sudden cardiac arrest (SCA), at an outlying facility 5-years ago, was admitted with chest pain. The patient has an implantable cardioverter defibrillator (ICD), placed at the outlying facility 5 years ago for secondary prevention, though a work-up for SCA at that time was unremarkable—reportedly negative coronary angiogram. Per patient, a cardiac magnetic resonance was not performed prior to ICD implantation.

On this admission, a cardiac computed tomography angiography (CCTA) of the torso was performed in the emergency department that was negative for active aortic disease. An initial EKG showed atrial fibrillation, septal infarct pattern, and T-wave inversion in the anterolateral leads (Figure  1). The patient underwent a myocardial...



The authors declare that they have no conflict of interest to disclose.


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Copyright information

© American Society of Nuclear Cardiology 2018

Authors and Affiliations

  1. 1.Division of Cardiovascular Diseases, Jacobs School of Medicine and Biomedical SciencesUniversity at BuffaloBuffaloUSA

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